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Sleep Related Questionnaires

Home ▶ Members ▶ Assemblies and Sections ▶ Assemblies ▶ Sleep and Respiratory Neurobiology ▶ Sleep Related Questionnaires ▶ Epworth Sleepines Scale (ESS)


Epworth Sleepines Scale (ESS)
Name of questionnaire Epworth Sleepines Scale (ESS)
Type of original questionnaire-description, age/population Measure of sleepiness in daily life. The ESS asks the patient to rate their likelihood of falling asleep under 8 different circumstances.
Number of items 8
Number of domains/categories 1
Name of categories/domains   Propensity of falling asleep
Scaling of items  4-point scale (0 – 3)
Scoring available: with permission or free Free for individual users and non-funded academic research. For further information, it is recommended to contact Mapi Research Trust in France.
Scoring test-retest reliability Test-retest reliability varied between 0.81 and 0.93 measured over a few weeks to a few months, tested by intraclass correlation coefficient, in five separate investigations.
Scoring Internal consistency Cronbach’s alpha varied between 0.73 and 0.90 (mean = 0.82) in ten separate investigations
Validity The ESS had a statistically significant association with self-rated problem sleepiness but low correlation with mean sleep latency (r=0.51) or measures of sleep apnea severity.
Language English, initially developed for Australia.
Translations in other languages (if yes, then list the languages) 66 languages (e.g., Arabic, Chinese, Croatian, French, German, Greek, Italian, Hindi, Japanese, Korean, Mandarin, Norwegian, Persian, Peruvian, Portuguese, Serbian, Spanish, Thai, Turkish, Urdu)
Developer name

Dr. Murray Johns
Developer contact information for permission

Dr Murray Johns
c/o Optalert Ltd
Level 3, Building 5, 658 Church Street
Richmond, Melbourne, Victoria 3121,
Australia
Telephone: +61 3 9425 5000
Facsimile: +61 3 9425 5001

MAPI Research Trust
PRO Information Support
27 Rue de la Villette, 69003 Lyon, France
Phone: +33 (0) 4 7213 6575
Fax: +33 (0) 4 7213 6682

Email: 
PROinformation@mapi-trust.org
https://eprovide.mapi-trust.org/instruments/epworth-sleepiness-scale
Availability of questionnaire: needs permission from developer, cost or freely available

Free of charge to individual clinicians and researchers.
Organizations require a license to use it.
All license arrangements are given by Mapi Research Trust in France.
Limitations

Recall bias because retrospective reports.
Subjective measure that has no close relationship with objective measures (such as mean sleep latencies of multiple sleep latency test MSLT). No statistically or clinically significant association between Epworth scores and mean sleep latency test, suggesting that the 2 tests may evaluate different, complementary aspects of sleepiness.
Link to the questionnaire (if available)

http://epworthsleepinessscale.com/about-the-ess/
Other comments Scored using 4-point scale (0 – 3) for each of the eight items (0: no chance of dozing, 1: slight chance, 2: moderate chance, 3: high chance of dozing)
Normal range: 0-10
Excessive daytime sleepiness (EDS) >10
Mild EDS: 11-12
Moderate EDS: 13-15
Severe EDS: 16-24
Patient populations in who questionnaire has been validated Adults
References

Original Publication:

  1. Johns MW. A new method for measuring daytime sleepiness: the Epworth Sleepiness Scale. Sleep 1991; 50-55.

 Validity and reliability in different populations:

  1. Rosenberg R, Babson K, Menno D, Morris S, Baladi M, Hyman D, Black J. Test-retest reliability of the Epworth Sleepiness Scale in clinical trial settings. J Sleep Res. 2022 Apr;31(2):e13476.
  2. Lipford MC, Wahner-Roedler DL, Welsh GA, Mandrekar J, Thapa P, Olson EJ. Correlation of the Epworth Sleepiness Scale and Sleep-Disordered Breathing in Men and Women. J Clin Sleep Med. 2019 Jan 15;15(1):33-38.
  3. Sanford SD, Lichstein KL, Durrence HH, Riedel BW, Taylor DJ, Bush AJ. The influence of age, gender, ethnicity, and insomnia on Epworth sleepiness scores: a normative US population. Sleep Med. 2006 Jun;7(4):319-26.
  4. Nishiyama T, Mizuno T, Kojima M, Suzuki S, Kitajima T, Ando KB, Kuriyama S, Nakayama M. Criterion validity of the Pittsburgh Sleep Quality Index and Epworth Sleepiness Scale for the diagnosis of sleep disorders. Sleep Med. 2014 Apr;15(4):422-9.
  5. Kendzerska TB, Smith PM, Brignardello-Petersen R, Leung RS, Tomlinson GA. Evaluation of the measurement properties of the Epworth sleepiness scale: a systematic review.Sleep Med Rev. 2014 Aug;18(4):321-31.
  6. Baumgartel KL, Terhorst L, Conley YP, Roberts JM. Psychometric evaluation of the Epworth sleepiness scale in an obstetric population.Sleep Med. 2013 Jan;14(1):116-21. 
  7. Godoy PH, Nucera APCDS, Colcher AP, de Andrade JE, Alves DDSB. Screening for obstructive sleep apnea in elderly: performance of the Berlin and STOP-Bang questionnaires and the Epworth sleepiness scale using polysomnography as gold standard. Sleep Sci. 2022 Apr-Jun;15(2):136-142.

Long/short versions:

9. Zhang JN, Peng B, Zhao TT, Xiang M, Fu W, Peng Y. Modification of the Epworth Sleepiness Scale in Central China. Qual Life Res. 2011 Dec;20(10):1721-6.
   
Updated by Marie-Anne Melone, MD
The last date of update November  2022